Abstract
Functional outcome following restorative proctocolectomy depends, in part, on the volume of the pouch. This study investigates the relationship between the length of ileum and volume of saline required to distend the ileum to a set pressure, and the possibility of predicting the volume of an ileoanal pouch using these measurements. Measurements were made on the ileum of 8 mongrel dogs. There was a linear relationship between the length of ileum and volume of saline infused to produce an intraluminal pressure of 20 mmHg (r=0.94-0.99). However, the capacity of ileum varied widely from animal to animal (100 cc of saline filled 15.5 cm to 43 cm of ileum). Twenty-four pouches (15J, 9S) were constructed from segments of ileum of known capacity. The capacity of a J pouch was 1.7±0.11 times greater than the capacity of the original length of bowel and an S pouch had a capacity 2.14±0.25 times greater. These changes in capacity are similar to a theoretical calculation of change in volume of ileum after pouch construction. This technique is a simple, quick method of predicting the volume of an ileo-anal pouch which will be useful in a clinical trial to compare function of pouches of different volumes.
Résumé
La résultat fonctionnel des proctocolectomies avec réservoir iléo-anal résulte en partie du volume de la poche. Ce travail étudie la relation entre la longueur de l'iléon et le volume de sérum nécessaire pour distendre l'iléon jusqu'à une pression donnée ainsi que la possibilité de prédire le volume d'une poche iléoanale sur la base de ces mesures. Les mensurations ont été obtenues sur l'iléon de 8 chiens. Une relation linéaire s'établit entre la longueur de l'iléon et le volume de sérum à infuser pour obtenir une pression intraluminale de 20 mmHg (r=0,94-0,99). La capacité de l'iléon varie toutefois grandement d'un animal à l'autre (100 ml de soluté physiologique pour remplir de 15,5 cm à 43 cm d'iléon). Vingt quatre poches (15J, 9S) ont été confectionnées à partir de segments d'iléon de capacité connue. La capacité d'une poche en J est 1,71±0,11 fois supérieure à la capacité de la longueur originale de l'intestin et une poche en S a une capacité de 2,14±0,25 fois supéricure à la capacité originale de l'intestin. Ces changements dans la capacité sont similaires à ceux que l'on peut calculer de manière théorique dans le volume de l'iléon après confection d'une poche. Cette technique est simple et permet un calcul rapide du volume d'une poche iléoanale; elle sera particulièrement utile dans des études cliniques pour comparer le fonctionnement de poches de différents volumes.
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References
Wong WD, Rothenberger DA, Goldberg SM (1985) Ileoanal pouch procedures. Curr Probl Surg 22:1–78
Wexner SD, Jensen L, Rothenberger DA et al (1989) Long-term functional analysis of ileoanal reservoir. Dis Colon Rectum 32:275–281
Nicholls RJ, Pezim ME (1985) Restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial adenomatous polyposis: a comparison of three reservoir designs. Br J Surg 72:470–474
Taylor BM, Cranley B, Kelly KA et al (1983) A clinico-pathological comparison of ileal pouch-anal and straight ileoanal anstomoses. Ann Surg 198:462–468
Nasmyth DG, Johnston D, Godwin PGR et al (1986) Factors influencing bowel function after ileal pouch-anal anastomosis. Br J Surg 73:469–473
Sagar PM, Holdsworth PJ, Godwin PGR et al (1992) Comparison of triplicated (S) and quadruplicated (W) pelvic ileal reservoirs. Gastroenterol 102:520–528
O'Connell PR, Pemberton JH, Brown ML, Kelly KA (1987) Determinants of stool frequency after ileal pouch-anal anastomosis. Am J Surg 153:157–163
Becker JM, Raymond JL (1986) Ileal pouch-anal anastomosis. A single surgeon's experience with 100 consecutive cases. Ann Surg 204:376–381
Öresland T, Fasth S, Nordgren S et al (1990) Pouch size: the important functional determinant after restorative proctocolectomy. Br J Surg 77:265–269
Becker JM, Hillard AE, Mann FA et al (1985) Functional assessment after colectomy, mucosal proctectomy, and endorectal ileoanal pull-through. World J Surg 9:598–605
Hallgren T, Fasth S, Nordgren S, Öresland T, Hallsberg L, Hultén L (1989) Manovolumetric characteristics and functional results in three different pelvic pouch designs. Int J Colorect Dis 4:156–160
Thompson WHF, Simpson AHRW, Wheeler JL (1987) Mathematical prediction of ileal pouch capacity. Br J Surg 74:567–568
Soper NJ, Kestenberg A, Becker JM (1988) Experimental ileal J-pouch construction. A comparison of three techniques. Dis Colon Rectum 31:186–189
Luukkonen P, Järvinen H (1987) Pelvic ileal reservoirs: experimental assessment of reservoir capacity in three reservoir designs. Ann Chir Gynecol 76:294–297
Thayer ML, Madoff RD, Jacobs DM, Bubrick MP (1991) Comparative intrinisic and extrinsic compliance characteristics of S, J, and W ileoanal pouches. Dis Colon Rectum 34:404–408
Levitt MD, Kamm MA, Groom J, Nicholls RJ, Hawley PR (1992) Ileoanal pouch compliance and motor function. Br J Surg 79:126–128
Nasmyth DG, Williams NS, Johnston D (1986) A comparison of the function of triplicated and duplicated pelvic ileal reservoirs after mucosal proctectomy and ileo-anal anastomosis for ulcerative colitis and adenomatous polyposis. Br J Surg 73:361–365
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Williams, J.G., Heine, J.A., Stoller, D.L. et al. A method for predicting the volume of an ileo-anal pouch. Int J Colorect Dis 9, 100–104 (1994). https://doi.org/10.1007/BF00699422
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DOI: https://doi.org/10.1007/BF00699422